Dissatisfaction Rampant Among Community Hospital EHR Users

One in three customers who went live with an EHR in the last year believe they made the wrong decision, says KLAS report.

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One in three community hospitals that deployed an electronic health record (EHR) system within the past year are dissatisfied with their vendor of choice, says a new report from health consulting firm KLAS.

A third of those surveyed believed they made the wrong decision and reported they wouldn't buy the product again. Although vendor performance wasn't a focus of the study, KLAS reported vendors such as Healthland, Cerner, CPSI and Meditech have a high number of newly live, unsatisfied customers.

The report broke down the community hospital clinical information system market share for 2012. In it, report author Paul Pitcher wrote the market has been seeing "incredible churn" throughout the community, whether it was due to smaller hospitals buying for the first time, consolidation driving more single-vendor strategies, or hospitals replacing outdated or failing systems.

"KLAS has measured clinical market share in the larger hospital space for a number of years … but starting two years ago, we felt there was a need based on feedback from providers to measure the community hospital space as well," Pitcher said in an interview with InformationWeek Healthcare. "This is a reiteration of our first publication on community market share, which was released in 2011 and [documented] 2010 measurements."

Featured in the report is a ranking of vendors based on four main areas: Those that are deemed "healthy" by KLAS, those that fall into the "revolving door" category, those that are "new entrants" to the market space, and those vendors that are "at risk." Based on participant feedback, KLAS created a formula of wins and losses to determine vendor placement into these categories. For example, said Pitcher, a "win" for a vendor would be if a hospital that had no clinical information system adopts one, or if a hospital upgrades from a piece of revenue cycle technology to more clinical technology.

"There can be various definitions for a 'healthy' vendor, but essentially, they're experiencing a lot of wins relative to losses, and there's a lot of market energy around those vendors," said Pitcher. Vendors in this category included Epic, Cerner and McKesson's Paragon system. Vendors that fall into the "revolving door" category experience a lot of wins with their customers, continued Pitcher, yet they have some dissatisfaction among users, particularly those in smaller, critical access hospitals. These organizations tend to be dissatisfied "not exclusively, but they best represent what's going on with the revolving door vendors," he said. "These customers think the grass is always greener, and they're a little dissatisfied with [their systems]." Revolving door vendors included Healthland, CPSI, HMS, Siemens and Allscripts.

New entrant vendors, said Pitcher, are those "we weren't talking about two years ago but are beginning to gain market share and presence within healthcare." These vendors include Prognosis, NextGen and RazorInsights. "Now, there's more energy around them. They'll be the vendors to watch going forward because they bring newer IT, which gives them a leg up in winning market share," Pitcher said. Last, at-risk vendors include those that have "no energy" around their offerings. Vendors in this category included McKesson's Horizon suite, QuadraMed and Meditech, said Pitcher. "They had no energy or, like Meditech, have as many wins as they do losses," he said.

In addition to one in three customers dissatisfied with their recently deployed system, key findings in the report included new players gaining traction in the market. "It's interesting to see these vendors we haven't talked about getting market share and deals from more well-established vendors, etc.," said Pitcher. "It's an opportunity for new vendors with newer IT to displace these older legacy vendors, where poor performance is causing dissatisfaction," he said.

Market consolidation was a last key finding, and Pitcher said similar to other industries, such as airlines, healthcare is seeing consolidation among vendors due to larger organizations adopting smaller hospitals. "That becomes a way for the hospital to survive, but then their system may be displaced…. [W]e anticipate that trend will continue," he said.

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When I attend AAHAM and HFMA meetings for revenue cycle members, I am amazed at the number of facilities that are one to two years post conversion and are miserable with their EHR choicces. I am also surprised by the number of hospital and physician providers who are currently making plans for a migration to a newr EHR, but the finance teams have little to no say in the EHR decisions.

I once worked with a CEO who claimed during a EHR search, any system can produce a bill and collect money. Guess what: he was SO wrong.

Critical Access Hospitals, simply do not have the resources to support some of the really intense big EHR systems that are being sold to them.

Many issues that come up with implementation of an EHR don't come up until you're actually implementing it. It seems to make sense that would be the time to rethink your choice as you're having issues. There are many EHR vendors, but I think you'd be hard pressed to find one that offers everything along with great support. Maybe the grass is always greener... ?

That's disappointing, I though EHR systems were going to be state of the art and top notch. Especially with all the vendors that leaped onto the wagon. So the user's dissatisfied with the vendors but are they happy with the EHR systems and their capabilities?